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- Title
Safety and Feasibility of Simultaneous Transcarotid Revascularization With Flow Reversal and Coronary Artery Bypass Grafting for Concomitant Carotid Artery Stenosis and Coronary Artery Disease.
- Authors
Williams, Zachary; Olivere, Lindsey A.; Gilmore, Brian; Weissler, Hope; Cox, Mitchell W.; Long, Chandler; Shortell, Cynthia K.; Schroder, Jacob; Southerland, Kevin W.
- Abstract
Objective: The management of patients with combined severe carotid artery and coronary artery disease (CAD) is controversial. Transcarotid stenting with flow reversal (TCAR) is a novel hybrid technique for carotid revascularization. We sought to investigate the safety and feasibility of simultaneous TCAR and coronary artery bypass grafting (CABG) for concomitant carotid and CAD. Methods: A single-institution, retrospective study of patients with critical carotid artery stenosis and symptomatic CAD who underwent simultaneous TCAR-CABG was completed. The primary outcomes were technical success, perioperative stroke, death, and hemorrhage. Results: Four patients underwent TCAR-CABG. All patients were male with a mean age of 64. Technical success was achieved in all cases. There were no perioperative strokes or deaths. There were no reexplorations for hemorrhage. Conclusions: Transcarotid stenting with flow reversal-CABG is a technically feasible hybrid approach for simultaneous carotid and coronary revascularization. It should be part of the vascular surgeon's armamentarium for coexisting carotid and coronary disease. Further research focused on patient selection and perioperative antiplatelet management is warranted prior to the widespread adoption of this technique.
- Subjects
CORONARY heart disease surgery; SURGICAL complication risk factors; HEMORRHAGE risk factors; MORTALITY risk factors; STROKE risk factors; CORONARY artery bypass; MYOCARDIAL revascularization; RISK assessment; SURGICAL stents; CAROTID artery stenosis; TREATMENT effectiveness; RETROSPECTIVE studies; SEVERITY of illness index; MIDDLE age
- Publication
Vascular & Endovascular Surgery, 2020, Vol 54, Issue 5, p395
- ISSN
1538-5744
- Publication type
Article
- DOI
10.1177/1538574420918971